Nurse Practitioners

What is a Nurse Practitioner?

Although nurse practitioners have been practicing under Oregon state law for over 30 years, many patients do not have a clear understanding of what a nurse practitioner is and how they differ from nurses and physicians. Since nurse practitioners are licensed and qualified to provide many of the same services that patients frequently receive from both nurses and primary care physicians, the confusion is understandable.

Advanced Practice Nursing and the Nurse Practitioner

Nurse practitioners are nurses who have received a master’s degree in nursing, and further education and clinical training in primary care medicine, pharmacology, and skills specific to any area of specialty they choose (such as pediatrics, geriatrics, mental health, or women’s health). Following this additional education and clinical experience, they may take a national certification exam, and be licensed as a nurse practitioner under Oregon law. They are then qualified to evaluate, provide, and coordinate comprehensive personalized health care.

A board-certified Nurse Practitioner is licensed to perform exams, provide holistic health care, manage health problems, diagnose illness, provide health counseling, prescribe medication as appropriate, and refer patients to other health care providers and specialists, as well as other responsibilities. A nurse practitioner is licensed to provide many of the same services as a physician in Oregon. Many nurse practitioners work for physicians to help them serve more patients in need of the most common health care services. Other nurse practitioners work independently and by collaboration and referral with other nurse practitioners, physicians, specialists, and community resources to provide patients with services beyond their own scope of practice.

You’ll find another, more detailed explanation of nurse practitioners from the Nurse Practitioners of Oregon here.

What’s the difference between a physician (MD) and a Nurse Practitioner?

The difficulty in defining the role of the nurse practitioner stems from the fact that nurse practitioners’ work often straddles the line between the work of nurses and physicians. Like nurses, they collect health histories, conduct physical exams, provide disease management, and do certain procedures like giving shots, drawing blood samples, etc. Like physicians they order lab tests, provide diagnosis, prescribe medications, and counsel and educate patients and families.

Nurse practitioners are limited to seeing patients that fall within their scope of practice (a list of requirements that are usually determined on a national level). If a patient requires treatment that does not fall into the nurse practitioners scope of practice, that patient is referred to a physician or other resource for further care. Physicians often have more latitude in handling more specialized conditions or treatments directly, but also refer patients to specialists (like cardiologists or urologists) for specific diagnosis and treatment.

Nurse practitioner’s work is especially geared toward teaching patients about long term health maintenance and disease avoidance. In a setting which allows time for this interaction between the nurse practitioner and patient, this focus on discussing patient’s concerns and providing health education is often the feature that patients will notice most when seeing a nurse practitioner.

Of course, every nurse practitioner and physician are unique, so some nurse practitioners may have specialized education that expands their scope of practice, and some physicians may have a special interest and skill in providing detailed patient education.

Are Nurse Practitioners as good as physicians?

There have been several research studies that compare outcomes such as patient satisfaction, patient care, need for urgent care between NPs and MDs. For more information see the following:

Comparing NP and MD primary care outcomes: Two-year follow-up
…the primary health care delivered by NPs and MDs is equal in quality.

Empathy: An NP/MD comparison

Randomized Trial of Nurse Practitioner/Community Health Worker Intervention…
…An intensive Nurse Practitioner/Community Health Worker intervention… dramatically improved several dimensions of patient satisfaction with medical care for high blood pressure [in a selected group of patients].